Doc: Night visions may be sign of type of a dementia

Dear Dr. Roach: I am an extremely healthy 76-year-old woman. Almost every night, I am startled awake by visions of people standing over my bed. It’s usually once, but can happen up to three times in a night. It’s often after being asleep for an hour and a half.

They’re not dreams. Something wakes me up, and that is when I see a man or a couple or a child standing around my bed or attempting to jump onto the bed. Though it lasts only seconds, my heart hammers and I jump out of bed to chase “them” away, and even checking the door locks. Then I sort of come around and pretty much laugh at myself. As it’s quite frightening, I believe I shout out, and it takes me a bit to calm back down.

I take NO prescription drugs nor sleep-inducing medicine. Why am I experiencing this? What actually wakes me up to see these visions? Otherwise, I sleep very well. I would greatly appreciate your insight or any advice as to who I might talk with about it. Anon.

Dear Anon: I hesitate to tell you, but what I am concerned about most is a condition called dementia with Lewy bodies. This is not Alzheimer’s disease. In fact, the earliest symptoms are usually visual hallucinations.

What makes me doubt this diagnosis is that you report no confusion or memory problems. Although some people may have the hallucinations well before any thinking problems come up, they are in a minority. Wobbliness may go along with Lewy body dementia. Parkinson’s disease may develop visual hallucinations, but that is usually late in the course of the disease.

This information can be shocking or depressing, but it is still important information for you to have. There is treatment for LBD. More importantly, there are medications that can make it MUCH worse.

I would recommend you visit a neurologist and specifically find someone with expertise in dementia, as that is who is unlikely to miss this diagnosis. Unfortunately, it is not always recognized early.

Dr. Roach writes: A recent column confused the brand name of a common prostate treatment. Cardura is the brand name for doxazosin, while Flomax is the brand name of tamsulosin. These are similar medications that work by relaxing the muscle inside the prostate gland, allowing urine to flow more freely through the urethra, which runs right through the prostate gland. These medicines are called alpha blockers and they start working right away, as opposed to the dihydrotestosterone blockers – dutasteride (Avodart) and finasteride (Proscar) – which take months to reach maximum effectiveness. I apologize for the error.